Abstract
Background: Although smoking-cessation interventions typically focus directly on patients, this paper conducts an economic evaluation of a novel smoking-cessation intervention focused on training physicians and/or pharmacists to use counseling techniques that would decrease smoking rates at a reasonable cost. Purpose: To evaluate the cost-effectiveness of interventions that train physicians and/or pharmacists to counsel their patients on smoking-cessation techniques. Methods: Using decision-analytic modeling, we compared four strategies for smoking-cessation counseling education: training only physicians, training only pharmacists, training both physicians and pharmacists (synergy strategy), and training neither physicians nor pharmacists (i.e., no specialized training, which is the usual practice). Short-term outcomes were based on results from a clinical trial conducted in 16 communities across the Houston area; long-term outcomes were calculated from epidemiological data. Short-term outcomes were measured using the cost per quit, and long-term outcomes were measured using the cost per quality-adjusted life-year (QALY). Cost data were taken from institutional sources; both costs and QALYs were discounted at 3%. Results: Training both physicians and pharmacists added 0.09 QALY for 45-year-old men. However, for 45-year-old women, the discounted quality-adjusted life expectancy only increased by 0.01 QALY when comparing the synergy strategy to no intervention. The incremental cost-effectiveness ratio (ICER) of the synergy strategy with respect to the non-intervention strategy was US$868/QALY for 45-year-old men and US$8953/QALY for 45-year-old women. The results were highly sensitive to the quit rates and community size. Conclusion: Synergistic educational training for physicians and pharmacists could be a cost-effective method for smoking cessation in the community.
Original language | English (US) |
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Pages (from-to) | 79-86 |
Number of pages | 8 |
Journal | Addictive Behaviors |
Volume | 45 |
DOIs | |
State | Published - Jun 1 2015 |
Keywords
- Costs and cost analysis
- Medical decision making
- Nicotine
- Smoking cessation
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Clinical Psychology
- Toxicology
- Psychiatry and Mental health
MD Anderson CCSG core facilities
- Biostatistics Resource Group
- Clinical Trials Office